What are haemorrhoids?

Haemorrhoids are abnormal vascular tissue in the anal canal composed of dilated veins with their associated anal canal lining. The normal anal canal has veins underneath its lining but when these become dilated and or displaced outside the anal canal and start to cause symptoms of bleeding, prolapse and itching you have developed haemorrhoids.

Why banding?

Banding is an outpatient treatment for haemorrhoids and is used for larger bleeding haemorrhoids and prolapsing haemorrhoids. Banding is more effective than injection for prolapsing haemorrhoids but does cause more discomfort than injection. It may need to be repeated at six weekly intervals until the all haemorrhoids are dealt with.

How is banding performed?

Banding is an outpatient procedure performed without sedation. The haemorrhoids are sucked into a device that applies a tight rubber band around the neck of the offending tissue that then dies and is passed naturally. This process takes a few days.

Will it be painful?

Bands are placed above the “dentate line” in the anal canal where there are fewer nerve fibres but a dull ache is often reported by patients. It will usually respond to anti-inflammatories and paracetamol (best taken before the procedure if you know you are going to have it done). The pain and discomfort of banding is gone after about 8-12 hours. Some patients feel they need to pass a bowel motion after the bands are applied, but don’t strain on the toilet after the procedure. Very rarely the discomfort after banding is severe and the bands have to be removed.

Bleeding after banding

Bleeding can occur after banding up to two weeks after the procedure. The more severe form of bleeding is known as “secondary haemorrhage” and occurs after the haemorrhoid has separated. If you experience heavy bleeding with dripping of blood into the pan please contact me. It will usually settle spontaneously but will occasionally need intervention.

More information needed?

“Informed consent for surgery is a process not a piece of paper”! The expected outcome of surgery (return to health) must be weighed against the small chance of an adverse outcome or complication. If you require more information on any aspect of your condition or proposed treatment please make an appointment to discuss your concerns.

Useful websites

www.cssanz.org

www.fascrs.org

www.acpgbi.org.uk